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Query: UMLS:C0010200 (
cough
)
23,843
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A noncholinergic, nonadrenergic nervous system has been described, involving the sensory nerves in the airways. Chemicals, dusts and other irritants stimulate these sensory nerves to release substance P and related neuropeptides. These neuropeptides have the remarkable ability to affect multiple cells in the airways and to provoke many responses including
cough
, mucus secretion, smooth muscle contraction, plasma extravasation and neutrophil adhesion. This series of effects is termed "neurogenic inflammation." An enzyme exists on the surfaces of all lung cells that contain receptors for these neuropeptides. This enzyme,
neutral endopeptidase
(
NEP
), by cleaving and thus inactivating the neuropeptides, limits the concentration of the neuropeptide that reaches the receptor on the cell surface. Thus, neurogenic inflammatory responses are normally mild and presumably protective in nature. However, when
NEP
is inhibited pharmacologically (with
NEP
inhibitors) or by cigarette smoke, respiratory viral infection, or by inhalation of the industrial pollutant toluene diisocyanate, neurogenic inflammatory responses are exaggerated. Delivery of exogenous human recombinant
NEP
inhibits neurogenic inflammation. Finally, evidence is provided that corticosteroids suppress neurogenic plasma extravasation and that this drug can upregulate
NEP
in human airway tissue. Neutral endopeptidase cleaves multiple peptides. Thus, its selectivity resides, at least in part, on its fixed location on the surfaces of specific cells where it can modulate effects of peptides exposed to the cells' surfaces.
...
PMID:Neutral endopeptidase modulates neurogenic inflammation. 188 1
The enzyme
neutral endopeptidase
(
NEP
) is bound to the membranes of selected cells in the airways that have receptors for tachykinins. The location of the enzyme, along with its selectivity of substrates (tachykinins are a preferred substrate), allows the enzyme to cleave tachykinins that come close to the cell-surface receptors. By cleaving and thus inactivating tachykinins released during stimulation of the sensory nerves,
NEP
limits the degree of neurogenic inflammation. Neutral endopeptidase exists in the basal cells of the airway epithelium, nerves, smooth muscle, glands, blood vessels, and perhaps other cells. Thus, the enzyme modulates smooth muscle contraction, gland secretion,
cough
, vascular permeability, and neutrophil adhesion. Decreased
NEP
activity occurs with epithelial removal, during respiratory viral infections, and during exposure to irritants (e.g., cigarette smoke and toluene diisocyanate). Delivery of recombinant
NEP
(rNEP) by aerosol suppressed
cough
responses during neurogenic inflammation. We suggest that decreased
NEP
activity will result in exaggerated neurogenic inflammation and may play an important role in inflammatory diseases in airways. Furthermore, drugs that cause up-regulation of
NEP
may play a therapeutic role by suppressing neurogenic responses. Replacement therapy with rNEP may be useful in diseases where inflammatory peptides (e.g., tachykinins, bradykinin) play a role in pathogenesis.
...
PMID:Modulation of neurogenic inflammation by neutral endopeptidase. 200 87
In recent years, studies of the regulation of the airways have focused to an increasing degree on the roles of neuropeptides. Several peptides have been shown to be present in airways and mediate such diverse responses as ion transport, mucus secretion, bronchospasm or relaxation, edema,
cough
, changes in vascular permeability, and neutrophil chemotaxis. More recently, studies have described the roles of peptidases, most notably
neutral endopeptidase
(NEP, also known as
enkephalinase
, or E.C. 3.4.24.11) and kininase II (also known as angiotensin-converting enzyme, or E.C. 3.4.15.1) in modulating peptide-induced responses. The enzymes cleave a wide variety of peptides, generating metabolites that are inactive in the systems studied to date. Thus inhibitors of NEP potentiate responses to peptides that are cleaved by it. Therefore, NEP plays roles in modulating peptide-induced effects analogous to the role of acetylcholinesterase in modulating cholinergic neurotransmission. In several experimental respiratory diseases, the activity of
neutral endopeptidase
is decreased, resulting in increased responses to peptides. The therapeutic application of recombinant NEP protects the airways from the adverse actions of stimuli that release inflammatory peptides, and induction of the NEP gene expression by glucocorticoids suggest a possible mechanism for the action of these steroids in treating airway diseases such as asthma, chronic bronchitis, or cystic fibrosis.
...
PMID:Roles of neutral endopeptidase in airways. 201 45
Tachykinins, including substance P, are contained in sensory nerves of airways. Sensory nerve stimulation causes release of the tachykinins, thus producing a pattern of responses (smooth muscle contraction, submucosal gland secretion, increased vascular permeability, neutrophil adhesion, and
cough
) collectively referred to as "neurogenic inflammation". The responses to either exogenously or endogenously-released tachykinins are modulated selectively by
neutral endopeptidase
(
NEP
), an enzyme that exists on the membranes of cells that contain tachykinin receptors (e.g. submucosal glands, smooth muscle, postcapillary venous endothelium). By cleaving and thus inactivating the tachykinins,
NEP
limits their action on receptors. The reduced
NEP
activity associated with respiratory viral infections and inhaled irritants (e.g. toluene diisocyanate, cigarette smoke) potentiates neurogenic inflammatory responses. Exogenously delivered human recombinant
NEP
reduces responses to tachykinins. Thus, reduced
NEP
activity in tissues, by exaggerating inflammatory responses resulting from sensory nerve stimulation, may play an important role in the pathogenesis of inflammatory diseases in airways and in other tissues.
...
PMID:Neutral endopeptidase modulation of neurogenic inflammation in airways. 207 58
To study the roles of substance P and endogenous
neutral endopeptidase
in mediating
cough
, we measured
cough
responses in awake guinea pigs in response to exogenous substance P and capsaicin aerosols in the presence and absence of the
neutral endopeptidase
inhibitors leucine-thiorphan and phosphoramidon. Substance P stimulated
cough
in very low concentrations (10(-17)-10(-16) M). In a second study where the investigator did not know whether substance P or diluent alone was aerosolized, substance P (10(-16) M) caused
cough
. Leucine-thiorphan (10(-5) M) and phosphoramidon (10(-5) M) potentiated substance P-induced
cough
; NEP inhibitors also potentiated capsaicin-induced
cough
significantly. These findings suggest that substance P is a potent stimulator of
cough
responses, that capsaicin-induced
cough
is mediated by substance P or another similar neuropeptide, and that
cough
responses are modulated by endogenous
neutral endopeptidase
.
...
PMID:Neutral endopeptidase inhibitors potentiate substance P- and capsaicin-induced cough in awake guinea pigs. 246 67
To determine whether recombinant
enkephalinase
(
neutral endopeptidase
, EC 3.4.24.11) prevents
cough
induced by exogenously applied and endogenously released neuropeptides, we measured
cough
responses to aerosolized solutions of substance P or of capsaicin for 2 min in random-source guinea pigs before or after exposing them to aerosolized recombinant human
enkephalinase
. Substance P (10(-16) M) increased
coughing
compared with its vehicle. Enkephalinase (120 micrograms) inhibited
cough
induced by subsequent exposure to substance P compared with the response to substance P alone, but after further exposure to the
enkephalinase
inhibitor leucine-thiorphan (10(-5) M), substance P increased
cough
significantly. Similar results were obtained for capsaicin-induced
cough
. In pathogen-free guinea pigs, after they inhaled inactive recombinant
enkephalinase
(33 micrograms), capsaicin (10(-13) M) increased
cough
significantly. In contrast, after they inhaled active recombinant
enkephalinase
(33 micrograms), capsaicin increased
cough
only slightly. These results suggest that aerosolized
enkephalinase
reaches the sites of release or actions of endogenous neuropeptides and, by degrading them, prevents
cough
induced by their release. Furthermore, these studies suggest that recombinant
enkephalinase
might be useful in the treatment of
cough
and other symptoms of diseases involving peptides cleaved by this enzyme.
...
PMID:Recombinant human enkephalinase (neutral endopeptidase) prevents cough induced by tachykinins in awake guinea pigs. 247 75
Neuropeptides such as substance P are implicated in inflammation mediated by sensory nerves (neurogenic inflammation), but the roles in disease of these peptides and the peptidases that degrade them are not understood. It is well established that inflammation is a prominent feature of several airway diseases, including viral infections, asthma, bronchitis, and cystic fibrosis. These diseases are characterized by
cough
, airway edema, and abnormal secretory and bronchoconstrictor responses, all of which can be elicited by substance P. The effects of substance P and other peptides that may be involved in inflammation are decreased by endogenous
neutral endopeptidase
(NEP; also called
enkephalinase
, EC 3.4.24.11), which is a peptidase that degrades substance P and other peptides. In the present study, we report that rats with histories of infections caused by common respiratory tract pathogens (parainfluenza virus type 1, rat corona-virus, and Mycoplasma pulmonis) not only have greater susceptibility to neurogenic inflammatory responses than do pathogen-free rats but also have a lower activity of NEP in the trachea. This reduction in NEP activity may cause the increased susceptibility to neurogenic inflammation by allowing higher concentrations of substance P to reach tachykinin receptors in the trachea. Thus decreased NEP activity may exacerbate some of the pathological responses in animals with respiratory tract infections.
...
PMID:Neutral endopeptidase and neurogenic inflammation in rats with respiratory infections. 254 62
Water and secretions interact in airways to produce the sol and gel layers that allow for entrapment of foreign materials and subsequent clearance by ciliary movement and by
cough
. Active Cl ion transport produces fluid, and this process is activated by products of mast cells (leukotrienes), eosinophils (major basic protein), and by other inflammatory mediators (prostaglandins, bradykinin). Gland secretions produce the bulk of the volume of secretions. Airway irritation stimulates gland secretion reflexly via vagal muscarinic pathways. Recently, the sensory nerves have been discovered to release substance P and other neuropeptides when the airways are irritated. The stimulatory effects of neuropeptides on gland secretion (and on other inflammatory sites) are modulated by
enkephalinase
a membrane-bound enzyme that cleaves neuropeptides and thereby inactivates them. Up- or down-regulation of
enkephalinase
is predicted to change the degree of inflammatory response to neuropeptides. Finally, the cell surface of airway epithelial cells have been discovered to secrete large molecular weight glycoconjugates; these secreted products are increased markedly by a series of proteinases produced by inflammatory cells (neutrophils, mast cells) and by bacteria. Their exact physiologic roles are still unknown but they may contribute to the bulk and viscoelastic properties of airway secretions, and they may serve an important role in bacterial, viral and inflammatory cell adhesion.
...
PMID:Secretion and ion transport in airways during inflammation. 333 78
We examined an endogenous substance causing
cough
in awake guinea pigs. An intraperitoneal injection of phosphoramidon, a selective inhibitor of
neutral endopeptidase
(E.C. 3.4.24.11), caused
cough
in a dose-dependent fashion for approximately 40 min. At a dose of 3 x 10(-3) mol/kg, phosphoramidon caused a total of 11.6 +/- 1.4 coughs in 40 min. Phosphoramidon (3 x 10(-3) mol/kg)-induced
cough
was significantly inhibited by systemic pretreatment with capsaicin (p < 0.01). Aerosols of FK 888 (1 min), a specific inhibitor of substance P (NK1) receptor, inhibited phosphoramidon (3 x 10(-3) mol/kg)-induced
cough
in a dose-dependent fashion with complete inhibition at a dose of 10(-5) M. Likewise, aerosols of FK 224 (10(-5) M; 1 min), another inhibitor of NK1 and NK2 receptors, or lidocaine (4%, 1 min) significantly inhibited phosphoramidon (3 x 10(-3) mol/kg)-induced
cough
(p < 0.01). Furthermore, aerosols of FK 888 (10(-5) M; 1 min) significantly inhibited
cough
induced by cigarette smoke in awake guinea pigs (p < 0.01). These results suggest that substance P released from sensory nerves in the airway may be an endogenous substance causing
cough
and the substance P antagonist may be the drug for treatment of
cough
in respiratory disease.
...
PMID:Evidence for substance P as an endogenous substance causing cough in guinea pigs. 750 93
This review describes novel aspects of enzymes in the pertinent tissues of the airway and those associated with inflammatory cells. These include
neutral endopeptidase
, histamine N-methyltransferase, mast cell and neutrophil enzymes which have a potentially important role in the modulation of several airway functions such as bronchoconstriction, gland secretion, plasma extravasation and
cough
. Thus, regulation of enzyme activities in the airways may have new therapeutic implications in inflammatory diseases of airways.
...
PMID:Enzymatic modulation of bronchoconstriction, gland secretion, plasma extravasation and cough. 794 May 21
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